Bariatric Surgery Procedures
Our practice is unique in that it offers multiple weight loss procedures which our surgeons can tailor to your specific needs. Our patients follow a comprehensive program and typically lose 60-80% of their excess weight in the first year. In general, weight loss surgery success is defined as achieving a loss of 50% or more of excess body weight and maintaining that level for at least five years. Following surgery, most patients lose weight rapidly and continue to do so until 18 to 24 months after the procedure. More importantly, most people see significant improvement or even complete resolution of their associated health conditions such as diabetes and high blood pressure. There is no question that our patients see a dramatic improvement in their quality of life in just months after their surgery. We see miracles in our office every day!
Vertical Sleeve Gastrectomy
The laparoscopic vertical "sleeve" gastrectomy is the newest of the weight loss procedures. Our surgeons were among the first in the country to do this procedure and are two of the most experienced at performing the "sleeve" in the Southwest United States. Dr. Burpee & Dr. Chiasson began offering the procedure in 2004 as part of a two stage surgical approach for patients with a BMI greater than 60. These patients experienced excellent weight loss results, so we began offering this procedure to our general weight loss patients.
The laparoscopic vertical "sleeve" gastrectomy works by making the stomach smaller. Years of experience also shows that appetite is reduced by removing the part of the stomach that produces Grehlin (the hunger hormone). This surgery has very predictable results and our patients can expect to lose 60 - 80% of their excess body weight in the first year after surgery. Due to our experience both performing the operation and managing our patients afterwards, we believe that the Laparoscopic Vertical Sleeve Gastrectomy may eventually prove to be the most ideal weight loss procedure available. It is safe to perform, it yields predictable weight loss results, and it is associated with rare complications once the patient leaves the hospital. Moreover, should the patient not achieve adequate weight loss, it is very simple to convert the sleeve to a gastric bypass or duodenal switch operation as advocated in the two stage approach for super super obese patients.
Learn more about Vertical Sleeve Gastrectomy.
The gastric bypass is the second most common bariatric surgery procdure today. This operation was initially developed using an open technique. However, beginning with Alan Wittgrove in San Diego, this procedure has been performed using a laparoscopic technique since the mid-1990's. In the last 10 years, there have been many modifications made to the procedure as new technologies have evolved.
The gastric bypass operation works for three reasons. First, because the new stomach is very small, it limits or restricts the amount of food that a person can eat. Secondly, there is a hormone called Grehlin that is produced in the unused part of the stomach that affects appetite. Because this stomach is not used, the hormone level falls very low and patients generally lose their appetite for a period of 9-12 months. Finally, patients who have this surgery get dumping syndrome when they eat sweets. Consequently, as a form of aversion therapy, this operation helps patients make better food choices. It has very predictable results and one can expect to lose 60-80% of their excess body weight over the first year after surgery.
Learn more about Gastric Bypass.
Adjustable Gastric Band
The Laparoscopic Adjustable Gastric band known as the Realize Band or Lap Band procedure was a very popular weight loss procedure a decade ago but been largely replaced by the "sleeve" and the "bypass" to due lower and shorter-term weight loss results and higher complications. This procedure was developed in Europe and Australia in the 1990's. In 2001, the FDA gave its approval to the use of this implant for weight loss surgery in the United States.
This operation works by limiting or restricting the amount of food that a person can eat. This leads to weight loss. However, there are some issues with the band that differentiate it from gastric bypass and vertical sleeve gastrectomy. First, Grehlin hormone levels are not affected by this surgery. Patients do not lose their appetite to the same degree as with gastric bypass. Consequently, the weight loss associated with the Lap Band is generally slower and less predictable. Patients will generally lose 40-50 % of their excess body weight over the first 24 months after the surgery.
Learn more about Adjustable Gastric Band.
SADIS-S - Duodenal Switch
One of the most effective weight loss procedures is the duodenal switch. The duodenal switch is a surgery which combines the sleeve with the biliopancreatic diversion. There are several variations of this procedure. In our practice we offer the SADIS-S variation which stands for single anastomosis duodenal ileal switch & sleeve. The mechanism of action is a combination of neurohormonal—there is increased GLP 1 (‘I’m full’ hormone) and a decrease of ghrelin (‘I’m hungry’ hormone) and the majority of the small intestine is bypassed. SADIS-S weight loss surgery works for three reasons: 1) the size of the stomach is reduced to limit food intake; 2) the small intestine is "switched" around to alter the digestion process and limit calorie absorption; and 3) metabolic changes that decrease appetite and increase metabolism.
This bariatric operation has greatly improved the health and quality of life for many seriously obese individuals by helping them achieve and maintain significant long-term weight loss (up to 85% excess weight loss).
Learn more about Duodenal Switch.
These procedures involve converting a problematic weight loss surgery procedure such as a failed gastric band to a different type of weight loss surgery procedure. Weight loss surgery continues to evolve. To date, no single weight loss procedure has proven itself to be infallible to complications or failure with achieving adequate weight loss. Given its increased difficulty and risks, re-operative bariatric surgery has largely been limited or ignored by most bariatric surgeons. The growing number of weight loss procedures that are being performed will invariably lead to a greater need for this type of surgery. We have significant experience managing these patients including adjustable gastric band removals and are happy to accommodate these patients in our practice. Having said this, reoperative bariatric surgery is complex and we evaluate and accept our patients on a case-by-case basis.
Please contact our office to set up an appointment to discuss your options.
Orbera™ Intragastric Balloon
Non-Surgical Weight Loss Procedure
Dr. Chiasson and Dr. Burpee were the first bariatric surgeons in Arizona to be trained and certified in this procedure and they are the first bariatric surgeons in Arizona to perform it. The Orbera™ Balloon was developed for those patients that do not meet the standard criteria for the bariatric surgery options (BMI >40 or >35 with at least one comorbidity). Even though it was approved by the FDA in September 2015 for the U.S., this procedure has been performed on more than 220,000 patients in 80 countries for more than 20 years with great success. The procedure is meant to help expedite weight loss as a part of a 12 month behavioral, nutrition and fitness program, which is why our practice was selected by Apollo to be one of their first centers to offer the Intragastric Balloon. We have a long-established, highly regarded bariatric program that offers comprehensive care before and after bariatric surgery and the Orbera™ Balloon procedure so that our patients will be successful in achieving their long term weight loss goals.
Learn more about the Orbera™ Intragastric Balloon